1885 (2) NO. STa EE.T '
/,�`1;F41C�lON,FOR PLUMBING PERMIT
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E L DEC 21 9962 p' Sanitary N°.
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° < Date 6_ Permit No.
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Fee
° Apg-11,Y, Fcreti}lhpEp11N0it of Cupertino for permit to install Plumbing
o a pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
r and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
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Cupertino, and all o er laws applicable thereto.
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FIXTURES NUM E
UNITS FEES UNITS FEES
Water Heater Size
Water Closets Mateeal
Hath Tubs To Curb
Showers To Prop. Line
Lavatories To Existing
Kitchen Sinks Not Conn.
Dish Washers Sewer Boxes
Waste Disposals
Wash Trays STORM DRAINAGE
Washing Machines Size
Water SOFteners Material.
Liar Sinks To Main Drain
ComS. .Sink & Trays I To Curb
Dema!, Units
DdLying Fountains
Too'," Drains WATER SYSTEM
Hoppers Size
Restaurant Sinks Material
San Traps TOTAL FEES
Urinals Pixture Fee
Arca Drains Main Drain Fee,
Water Leaders Storm Drain Fee
7-prinklcr V111. Water Sys. Fee
Permit Fee
TOTAL TOTAL FEE
RECORD OF INSPECTION
Underground Rough...
.Partial Rough..
Rough. Complete..
\Iain Drain